Surgery of the Lungs: Pneumonectomy, Lobectomy, Sleeve Lobectomy, Wedge Resection, Segment Resection Home > Patient's Guide > Lung Surgery > Types of Lung Surgery A Patient's Guide to Lung Surgery Types of Lung Surgery Pneumonectomy A surgical procedure in which an entire lung is removed.A pneumonectomy is most often done for cancer of the lung that cannot be treated by removal of a smaller portion of the lung. A pneumonectomy is an open chest technique (thoracotomy). Lobectomy Also called a pulmonary lobectomy, it is a common surgical procedure that removes one lobe of the lung that contains cancerous cells. Removal of two lobes is called bilobectomy. Sleeve Lobectomy A surgical procedure that removes a cancerous lobe of the lung along with part of the bronchus (air passage) that attaches to it. The remaining lobe(s) is then reconnected to the remaining segment of the bronchus. This procedure preserves part of a lung, and is an alternative to removing the lung as a whole (pneumonectomy).

Wedge Resection A wedge resection is a surgical procedure during which the surgeon removes a small, wedge-shaped portion of the lung containing the cancerous cells along with healthy tissue that surrounds the area. The surgery is performed to remove a small tumor or to diagnose lung cancer. A wedge resection is performed instead of a lobectomy (removing a complete lung lobe) when there is a danger of decreased lung function if too much of the lung is removed. A wedge resection can be performed by minimally-invasive video-assisted thoracoscopic surgery (VATS) or a thoracotomy (open chest surgery). Segment Resection (Segmentectomy) A segment resection removes a larger portion of the lung lobe than a wedge resection, but does not remove the whole lobe. Pneumonectomy - procedure, recovery, blood, tube, removal, pain, complications, time Pneumonectomy Pneumonectomy is the medical term for the surgical removal of a lung. Purpose A pneumonectomy is most often used to treat lung cancer when less radical surgery cannot achieve satisfactory results.

It may also be the most appropriate treatment for a tumor located near the center of the lung that affects the pulmonary artery or veins, which transport blood between the heart and lungs. In addition, pneumonectomy may be the treatment of choice when the patient has a traumatic chest injury that has damaged the main air passage (bronchus) or the lung's major blood vessels so severely that they cannot be repaired. Demographics Pneumonectomies are usually performed on patients with lung cancer, as well as patients with such noncancerous diseases as chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. These diseases cause airway obstruction. Approximately 361,000 Americans die of lung disease every year. Lung disease is responsible for one in seven deaths in the United States, according to the American Lung Association. More than 25 million Americans are now living with chronic lung disease. Lung cancer Lung cancer is the leading cause of cancer-related deaths in the United States. It is expected to claim nearly 157,200 lives in 2003.

Lung cancer kills more people than cancers of the breast, prostate, colon, and pancreas combined. Cigarette smoking accounts for nearly 90% of cases of lung cancer in the United States. Lung cancer is the second most common cancer among both men and women and is the leading cause of death from cancer in both sexes. In addition to the use of tobacco as a major cause of lung cancer among smokers, second-hand smoke contributes to the development of lung cancer among nonsmokers. Exposure to asbestos and other hazardous substances is also known to cause lung cancer. Air pollution is also a probable cause, but makes a relatively small contribution to incidence and mortality rates. Indoor exposure to radon may also make a small contribution to the total incidence of lung cancer in certain geographic areas of the United States. In each of the major racial/ethnic groups in the United States, the rates of lung cancer among men are about two to three times greater than the rates among women. Among men, age-adjusted lung cancer incidence rates (per 100,000) range from a low of about 14 among Native Americans to a high of 117 among African Americans, an eight-fold difference.

For women, the rates range from approximately 15 per 100,000 among Japanese Americans to nearly 51 among Native Alaskans, only a three-fold difference. Chronic obstructive pulmonary disease The following are risk factors for COPD: current smoking or a long-term history of heavy smoking employment that requires working around dust and irritating fumes long-term exposure to second-hand smoke at home or in the workplace a productive cough (with phlegm or sputum) most of the time shortness of breath during vigorous activity shortness of breath that grows worse even at lower levels of activity a family history of early COPD (before age 45) Diagnosis/Preparation Diagnosis In some cases, the diagnosis of a lung disorder is made when the patient consults a physician about chest pains or other symptoms. The symptoms of lung cancer vary somewhat according to the location of the tumor; they may include persistent coughing, coughing up blood, wheezing, fever, and weight loss. In cases involving direct trauma to the lung, the decision to perform a pneumonectomy may be made in the emergency room.

Before scheduling a pneumonectomy, however, the surgeon reviews the patient's medical and surgical history and orders a number of tests to determine how successful the surgery is likely to be. In the case of lung cancer, blood tests, a bone scan, and computed tomography scans of the head and abdomen indicate whether the cancer has spread beyond the lungs. Positron emission tomography (PET) scanning is also used to help stage the disease. Cardiac screening indicates how well the patient's heart will tolerate the procedure, and extensive pulmonary testing (e.g., breathing tests and quantitative ventilation/perfusion scans) predicts whether the remaining lung will be able to make up for the patient's diminished ability to breathe. Preparation A patient who smokes must stop as soon as a lung disease is diagnosed. Patients should not take aspirin or ibuprofen for seven to 10 days before surgery. Patients should also consult their physician about discontinuing any blood-thinning medications such as coumadin or warfarin. The night before surgery, patients should not eat or drink anything after midnight. Description In a conventional pneumonectomy, the surgeon removes only the diseased lung itself. The patient is given general anesthesia.

An intravenous line inserted into one arm supplies fluids and medication throughout the operation, which usually lasts one to three hours. The surgeon begins the operation by cutting a large opening on the same side of the chest as the diseased lung. This posterolateral thoracotomy incision extends from a point below the shoulder blade around the side of the patient's body along the curvature of the ribs at the front of the chest. Sometimes the surgeon removes part of the fifth rib in order to have a clearer view of the lung and greater ease in removing the diseased organ.

A surgeon performing a traditional pneumonectomy then: deflates (collapses) the diseased lung ties off the lung's major blood vessels to prevent bleeding into the chest cavity clamps the main bronchus to prevent fluid from entering the air passage cuts through the bronchus staples or sutures the end of the bronchus that has been cut makes sure that air is not escaping from the bronchus inserts a temporary drainage tube between the layers of the pleura (pleural space) to draw air, fluid, and blood out of the surgical cavity closes the chest incision Aftercare Chest tubes drain fluid from the incision and a respirator helps the patient breathe for at least 24 hours after the operation. The patient may be fed and medicated intravenously. If no complications arise, the patient is transferred from the surgical intensive care unit to a regular hospital room within one to two days. A patient who has had a conventional pneumonectomy will usually leave the hospital within 10 days.

Aftercare during hospitalization is focused on: relieving pain monitoring the patient's blood oxygen levels encouraging the patient to walk in order to prevent formation of blood clots encouraging the patient to cough productively in order to clear accumulated lung secretions If the patient cannot cough productively, the doctor uses a flexible tube (bronchoscope) to remove the lung secretions and fluids. Recovery is usually a slow process, with the remaining lung gradually taking on the work of the lung that has been removed. The patient may gradually resume normal non-strenuous activities. A pneumonectomy patient who does not experience postoperative problems may be well enough within eight weeks to return to a job that is not physically demanding; however, 60% of all pneumonectomy patients continue to struggle with shortness of breath six months after having surgery. Risks The risks for any surgical procedure requiring anesthesia include reactions to the medications and breathing problems. The risks for any surgical procedure include bleeding and infection.

Between 40% and 60% of pneumonectomy patients experience such short-term postoperative difficulties as: prolonged need for a mechanical respirator abnormal heart rhythm (cardiac arrhythmia); heart attack (myocardial infarction); or other heart problem pneumonia infection at the site of the incision a blood clot in the remaining lung (pulmonary embolism) an abnormal connection between the stump of the cut bronchus and the pleural space due to a leak in the stump (bronchopleural fistula) accumulation of pus in the pleural space (empyema) kidney or other organ failure Over time, the remaining organs in the patient's chest may move into the space left by the surgery. This condition is called postpneumonectomy syndrome; the surgeon can correct it by inserting a fluid-filled prosthesis into the space formerly occupied by the diseased lung. Normal results The doctor will probably advise the patient to refrain from strenuous activities for a few weeks after the operation. The patient's rib cage will remain sore for some time.

A patient whose lungs have been weakened by noncancerous diseases like emphysema or chronic bronchitis may experience long-term shortness of breath as a result of this surgery. On the other hand, a patient who develops a fever, chest pain, persistent cough, or shortness of breath, or whose incision bleeds or becomes inflamed, should notify his or her doctor immediately. Morbidity and mortality rates In the United States, the immediate survival rate from surgery for patients who have had the left lung removed is between 96% and 98%. Due to the greater risk of complications involving the stump of the cut bronchus in the right lung, between 88% and 90% of patients survive removal of this organ. Following lung volume reduction surgery, most investigators now report mortality rates of 5–9%. Alternatives Lung cancer The treatment options for lung cancer are surgery, radiation therapy, and chemotherapy, either alone or in combination, depending on the stage of the cancer. After the cancer is found and staged, the cancer care team discusses the treatment options with the patient.

In choosing a treatment plan, the most significant factors to consider are the type of lung cancer (small cell or non-small cell) and the stage of the cancer. It is very important that the doctor order all the tests needed to determine the stage of the cancer. Other factors to consider include the patient's overall physical health; the likely side effects of the treatment; and the probability of curing the disease, extending the patient's life, or relieving his or her symptoms. Chronic obstructive pulmonary disease Although surgery is rarely used to treat COPD, it may be considered for people who have severe symptoms that have not improved with medication therapy. A significant number of patients with advanced COPD face a miserable existence and are at high risk of death, despite advances in medical technology. This group includes patients who remain symptomatic despite the following: smoking cessation treatment with antibiotics for acute bacterial infections, and inhaled or oral corticosteroids use of supplemental oxygen with rest or exertion pulmonary rehabilitation After the severity of the patient's airflow obstruction has been evaluated, and the foregoing interventions implemented, a pulmonary disease specialist should examine him or her, with consideration given to surgical treatment. Surgical options for treating COPD include laser therapy or the following procedures: Bullectomy.

This procedure removes the part of the lung that has been damaged by the formation of large air-filled sacs called bullae. Lung volume reduction surgery. In this procedure, the surgeon removes a portion of one or both lungs, making room for the remaining lung tissue to work more efficiently. Its use is considered experimental, although it has been used in selected patients with severe emphysema. Lung transplant. In this procedure a healthy lung from a donor who has recently died is given to a person with COPD. Resources Argenziano, Michael, M.D., and Mark E. Ginsburg, M.D., eds. Lung Volume Reduction Surgery , 1st ed. Totowa, NJ: Humana Press, 2002. Devita, Vincent T., Samuel Hellman, and Steven A. Rosenberg, eds. Cancer: Principles and Practice of Oncology , 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins Publishers, 2001. Henschke, Claudia I., Peggy McCarthy, and Sarah Wernick. Lung Cancer: Myths, Facts, Choices—And Hope , 1st ed. New York, NY: W. W.

Norton & Company, Inc., 2002. Johnston, Lorraine. Lung Cancer: Making Sense of Diagnosis, Treatment, and Options . Sebastopol, CA: O'Reilly & Associates, 2001. Pass, H., M. D., D. Johnson, M. D., James B. Mitchell, PhD., et al., eds. Lung Cancer: Principles and Practice , 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins, 2000. periodicals Crystal, Ronald G. "Research Opportunities and Advances in Lung Disease." Journal of the American Medical Association 285 (2001): 612-618. Grann, Victor R., and Alfred I. Neugut. "Lung Cancer Screening at Any Price?" Journal of the American Medical Association 289 (2003): 357-358. Mahadevia, Parthiv J., Lee A. Fleisher, Kevin D. Frick, et al.

"Lung Cancer Screening with Helical Computed Tomography in Older Adult Smokers: A Decision and Cost-Effectiveness Analysis." Journal of the American Medical Association 289 (2003): 313-322. Pope, C. Arden, III, Richard T. Burnett, Michael J. Thun, et al. "Lung Cancer, Cardiopulmonary Mortality, and Long-Term Exposure to Fine Particulate Air pollution." Journal of the American Medical Association 287 (2002): 1132-1141. organizations American Cancer Society. 1599 Clifton Road, N.E., Atlanta, GA 30329-4251. (800) 227-2345. . American Lung Association, National Office. 1740 Broadway, New York, NY 10019. (800) LUNG-USA. . National Cancer Institute (NCI), Building 31, Room 10A03, 31 Center Drive, Bethesda, MD 20892-2580.

Phone: (800) 4-CANCER. (301) 435-3848. . National Comprehensive Cancer Network. 50 Huntingdon Pike, Suite 200, Rockledge, PA 19046. (215) 728-4788. Fax: (215) 728-3877. . National Heart, Lung and Blood Institute (NHLBI). 6701 Rockledge Drive, P.O. Box 30105, Bethesda, MD 20824-0105. (301) 592-8573. . other Pneumonectomy | definition of pneumonectomy by Medical dictionary Pneumonectomy | definition of pneumonectomy by Medical dictionary pneumonectomy [noo″mo-nek´to-me] excision of lung tissue, of an entire lung (total pneumonectomy) or less (partial pneumonectomy), or of a single lobe ( lobectomy ). Patient Care.

Pneumonectomy is most often done as a treatment for lung cancer; it is also done with less common diseases such as extensive unilateral tuberculosis, bronchiectasis, and multiple abscesses of the lung. Thus patients who have a pneumonectomy are likely to have suffered some chronic and debilitating illness prior to surgery and will have special needs to avoid complications and promote healing and recovery. After surgical removal of a lung, the chest is closed and there is no closed drainage of the thoracic cavity. Instead, pressure within the pleural space is adjusted by using a simple thoracentesis and manometer, which help maintain the mediastinum midline. Fluid and air are allowed to accumulate in the space left by the excised lung to prevent shift of the mediastinum to the operative side. A second reason for not inserting a chest tube and drainage is the danger of contamination and possible empyema. The patient is not allowed to lie on the operative side. If the operative lung is permitted to be dependent, fluid can enter the space, causing tension pneumothorax secondary to mediastinal shift; should the bronchial stump rupture, drowning in the accumulated fluid could occur.

Fluid balance is watched closely by pressure monitoring to avoid overhydrating the patient. A central venous line or Swan-Ganz catheter may be used to guide fluid replacement. Serial blood gases and chest x-rays are done to detect early signs of respiratory complications. Additionally, blood tests are done and electrolyte levels are evaluated to detect problems of infection and imbalance. The most common postoperative complication is respiratory insufficiency, especially in patients who have had poor pulmonary function before surgery. Signs of respiratory problems include a change in mental status related to hypoxia, fever, tachycardia, and tachypnea. Pain is managed with analgesics on a routine basis. In addition to providing comfort and rest for the patient, analgesics allow the patient to move more freely and cough up accumulated secretions more effectively. Pulmonary hygiene is a vital component of postoperative care as it helps the remaining lung increase its vital capacity and total lung capacity and avoid atelectasis. In patients who are over 60 years of age or have a preexisting cardiac disease, there is the possibility that cardiac arrhythmias can develop. Pain, hypoxemia, hypovolemia, and acid-base imbalance can contribute to this complication.

A fistula between the bronchus and pleura sometimes occurs, leading to subcutaneous emphysema and mediastinal shift caused by a massive air leak. If the fistula is evident on the first or second postoperative day, it is probably due to a slipped ligature on the bronchial stump. An air leak that occurs later, on the fifth to tenth postoperative day, is probably due to an infection and poor wound healing. A ruptured bronchial stump must be repaired surgically as soon as possible. Signs that a stump has ruptured include dyspnea, change in mental status, and expectoration of serosanguineous fluid. Hemorrhage, usually due to a slipped ligature on a major artery, is a relatively rare complication, but when it occurs it can be fatal. The patient rapidly goes into profound shock from circulatory collapse. This complication must be detected early and corrected promptly. Patients recovering from pneumonectomy require intensive care to avoid the life-threatening complications listed above. Central pressure monitoring, continuous cardiac monitoring, serial laboratory testing of arterial blood gases and electrolyte levels, and frequent periodic checking of vital signs are all necessary either to avoid or to detect and manage these complications in their earliest stages.

Additionally, expert care by each member of an interdisciplinary team is necessary to assure an uneventful recovery and restoration of patients to their former daily activities. Pneumonectomy. From Polaski and Tatro, 1996. pneu·mo·nec·to·my (nū'mō-nek'tō-mē), Pneumonectomy - Medical Disability Guidelines Overview | Reason for Procedure | How Procedure is Performed | Prognosis | Specialists | Rehabilitation | Comorbid Conditions | Complications | Factors Influencing Duration | Length of Disability | Ability to Work | Medical Codes | Procedure Costs | References Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work. Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects. Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects. Job Classification In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication. Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work. Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects. Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects. Pneumonectomy Obesity Factors Influencing Duration Factors influencing the length of disability include the stage of the disease when first diagnosed, the individual's age and general health, and the type of tumor and its growth rate. Previous lung surgery may influence disability. Following pneumonectomy, the number and severity of postoperative complications (such as wound infection , bleeding, pneumonia, respiratory insufficiency, or an adverse reaction to a general anesthetic), the amount of blood loss during surgery and postoperatively, the number of blood transfusions required, the individual's nutritional status and mental and emotional stability, access to rehabilitation facilities, demands of the job, and the strength of the individual's support system are other factors that influence disability.

Medical Codes Source: Medical Disability Advisor Reason for Procedure Pneumonectomy is performed to treat lung cancer when tumors cannot be treated effectively with removal of an affected lobe ( lobectomy ), removal of the tumor mass with segmental resection of lung tissue and nearby lymph nodes, radiation therapy alone or chemotherapy alone. Lung cancer will most likely to be treated with pneumonectomy in individuals who have had no metastases to lymph nodes at the time of diagnosis. Pneumonectomy may also be used to treat chronic bronchiectasis and multiple abscesses of the lung . Source: Medical Disability Advisor How Procedure is Performed To perform a pneumonectomy, the surgeon usually approaches the lungs from the side through a thoracotomy incision. In cases in which a central mass is found, the surgeon may choose to approach the lungs from the front through the breastbone (median sternotomy incision), but this approach is much less common. For a thoracotomy approach, the individual is at first positioned on the back (supine position), and secured to the table with a safety belt across the upper thighs. Monitoring equipment is secured (temperature probe, ECG leads, and a pulse oximeter finger cot to measure the level of oxygen in the blood).

Intravenous lines are inserted for administration of fluids, medications, and blood during and after surgery. A special line to monitor arterial blood gases (oxygen and carbon dioxide) is also inserted. General anesthesia is administered and an endotracheal tube is placed through the mouth and into the windpipe (trachea), in order to maintain an airway and facilitate breathing. After being anesthetized, the individual is repositioned onto the non-operable side (lateral or semi-lateral position). (In some cases, the surgeon may decide to divide the breastbone in half to provide better access to the lungs. In this case, the individual remains positioned on the back.) Arms are secured and bony prominences (such as hip, ankle, and elbow) are padded to prevent pressure sores. A catheter may be inserted into the spine to be used for the delivery of pain medication postoperatively (epidural analgesia). Compression stockings may be applied to keep an even flow of blood moving through the legs during surgery, and prevent clot formation. A urinary catheter is inserted into the bladder and the tubing is hooked to a drainage bag in order to monitor kidney (renal) function during surgery.

A nasogastric tube may be passed through the nose and into the stomach to drain accumulated stomach secretions. A conduction pad may be secured on the thigh to prevent burns when blood vessels are cauterized with the electrocautery machine. The surgical area is washed (prepped) with an antibacterial solution, including the entire rib cage on the surgical side, from the middle of the back to the middle of the chest and stomach, and from the neck to below the hip. The individual is covered with sterile, moisture-proof surgical drapes, leaving the surgical area exposed (the entire rib cage on the surgical side). The head portion of the drape is lifted off of the individual's face and fastened to a canopy so that the entire head and neck is protected from the surgical field but exposed to the anesthesiologist. A sterile plastic adhesive drape is placed over the exposed surgical field. The individual's skin, underlying tissue, and muscle are cut (incised), usually between the fourth and fifth ribs. A rib may be removed to provide a better view. The ribs are separated with a rib retractor. The retractor is slowly cranked open, separating the ribs and exposing the diseased lung.

The surgeon uses scissors to open the membrane that surrounds the lung (pleura) and gently peel it away from the lung. All branches of the main blood vessels entering and leaving the lung (pulmonary artery and vein) are clamped, tied twice with nonabsorbable suture, and divided. The main air tube (bronchus) going from the windpipe (trachea) to the diseased lung is clamped and divided. The lung is removed from the chest. A piece of pleura may be used to cover the bronchus stump. The bronchus stump is then closed with nonabsorbable suture. The chest cavity is irrigated with sterile salt water (saline) to check for leaks in the bronchus stump, and to clear the chest of old blood. Bleeding is controlled with sutures and electrocautery. Chest tubes are not inserted after pneumonectomy as they are inserted after other lung surgeries. Following pneumonectomy, the chest cavity is allowed to fill with air and fluid. The levels are monitored so that just enough pressure is placed on the heart and other lung tissue to keep them in their normal space, without obstruction or drifting.

During closure, the muscle and each layer of tissue is closed with surgical sutures. The skin is closed with sutures and the suture line is covered with a thin layer of sterile gauze and secured with tape. The individual may be transferred directly to the Intensive Care Unit for recovery from anesthesia rather than transferring to the Recovery Room. Source: Medical Disability Advisor Prognosis The prognosis following pneumonectomy for lung cancer is usually poor; the exception may be in bronchoalveolar carcinoma if it is found as a single mass. If lung cancer is found early before it has spread to lymph nodes or other organs, the 5-year survival rate following surgery is 35 to 51% (Sekido 1427). However, the 5-year survival rate for all stages of lung cancer combined is 14%. Recurrence in the lungs after pneumonectomy is rare although the cancer may reappear in other organs. Following pneumonectomy, an individual may be able to return to work. As the disease progresses, however, the individual may become permanently disabled. Source: Medical Disability Advisor Rehabilitation Individuals who undergo pneumonectomy will require occupational, physical , and respiratory therapy after surgery.

All therapies will begin in the hospital, with occupational and physical therapy continuing after discharge from the hospital. The goal of respiratory therapy is to increase lung capacity and decrease risk for buildup of lung secretions. To accomplish this, the respiratory therapist may draw on a variety of breathing and coughing techniques. Occupational therapy addresses any fatigue or shortness of breath that may occur during activities of daily living. The therapy sessions may include learning to use equipment such as a shower chair to decrease the energy expended during bathing, or energy conservation techniques, in which activities of daily living such as meal preparation are broken up into smaller components to make tasks more manageable. Physical therapy addresses decreased endurance, strength, and range of motion. For example, the individual may learn to stretch shoulder and chest muscles on the side of the removed lung to help normalize posture, and strengthen the diaphragm by lying on the back and performing abdominal breathing exercises. The patient learns to rate the amount of energy expended in order to stay within safe exercise parameters.

Source: Medical Disability Advisor Complications Complications following pneumonectomy include collapsed lung ( atelectasis ), heart rhythm disturbances , air leakage from the bronchial stump ( pneumothorax ), hemorrhage, shifting of organs and tissue into the empty chest cavity (mediastinal shift), lung infection ( pneumonia ), accumulation of excess fluid in the empty chest cavity (pleural effusion), respiratory failure , and death. A ruptured bronchial stump requires immediate surgery, as does hemorrhage caused by slippage of a suture from one of the major pulmonary blood vessels that were cut and sutured during the pneumonectomy. Source: Medical Disability Advisor Ability to Work (Return to Work Considerations) Individuals who have had a pneumonectomy without experiencing serious postoperative complications or disabilities may be able to return to work part time 6 to 10 weeks after surgery. Hours of work may be gradually increased over the next several weeks until the individual is working a full shift, if that is possible. Individuals with chronic lung disease will most likely require work restrictions and accommodations that aid in conserving energy and reducing the load on the remaining lung. Most individuals with only one lung will experience some degree of shortness of breath even without exertion.

Individuals may not be able to perform heavy work due to the decreased ability to exchange gases through the remaining lung tissue. Other medical problems or permanent disabilities because of underlying medical conditions (such as diabetes , chronic renal failure requiring dialysis , chronic heart disease ) or postoperative complications may also require work restrictions and accommodations. References Cited Prager, Diane, et al. "Bronchogenic Carcinoma." Textbook of Respiratory Medicine. Eds. Jay Murray and John F. Nadel. 3rd ed. Philadelphia: W.B. Saunders, 2000. 1415-1416. Sekido, Yoshitaka. "Surgical Management." Textbook of Respiratory Medicine. Eds. Jay Murray and John F. Nadel. 3rd ed. Philadelphia: W.B. Saunders, 2000. 1427-1432. Source: Medical Disability Advisor Feedback Send us comments, suggestions, corrections, or anything you would like us to hear. If you are not logged in, you must include your email address, in order for us to respond. We cannot, unfortunately, respond to every comment. If you are seeking medical advice, please contact your physician.

Thank you! Send this comment to: Pneumonectomy ( Lung Removed ) | Cancer Survivors Network Cancer Survivors Network Members: Login to search all areas Not a member? Click here to search public areas CSN Login Joined: Sep 2009 Feb 13, 2010 - 7:07 pm Husband had his Left Lung ( entire lung ) removed last Mon. Feb. 8th.... I would like to hear from ANYONE who has had personal experience with this lung surgery... He is discouraged at how short of breath he is... I remind him that it's only been 5 days, encourage him to walk a little, and do the breathing treatment / exercise.. He came home yesterday / 4 days after surgery.... I feel very bad for him that he has to go thru this, but I must admit that I am so VERY TIRED.... 5 months the hospital has been our second home as we were BOTH diagnosed with cancer Same week in Sept. EVIL....DISEASE Log in or register to post comments ljw1121 Partial removal-left lung I know from a partial removal of the lung that it takes a few months to start to feel like ur breathing smewhat normal.

It took around 2-3mos and I still had the feeling of decreased breathing capacity. Increase exercise a little at a time and don't overdo it. Patience is hard but that's what it takes. It will get better. Log in or register to post comments DMP thinking about you Oh, Indy you and your husband are at the top of my prayer list tonight. I'm sitting here feeling sorry for myself, had upper left lobe removed 2/9, and look what you are going through. Of course you are exhausted. It has to be so much harder to have an entire lung removed (and for him to only stay such a short time) Has his had drain tube removed yet? This thing can be discouraging. Mine is still in and hurts so much I cannot do breathing treatment. I keep being told each day will get better, I am sure you are being told same thing. Also, while in hospital I was able to hide a lot of my crying and fears there away from my family; at home there's nowhere to run if I even could! Maybe your hubby just needs to let it out. I am also wondering if the pain meds we are on are causing at least some of the depression?

But can't get thru this without them. I don't have much advice about all this-found out it was cancer and had lobectomy same day-but I can be a good ear and good shoulder. What is going on with you? Know you are both in my thoughts and prayers-please let me know how you get on. Log in or register to post comments PBJ Austin Hello Indy I lost half of my right lung in September 2009. I was in the hospital for 7 days. When I got home I could barely walk across the house, and I do not have a big house. Walking to the mailbox was even more challenging. I was so depressed, thinking I would never be the same again. I think a big part of my depression was the painkillers, but of course they were quite necessary at the time. It has now been 5 months and I feel great!! I work out on my stair stepper and I take the stairs at work to my 8th floor office every day. I also walk several miles a day when the weather permits. I'm sure it's harder to lose a whole lung but I truly believe he will get better with time. Please don't feel so discouraged, this is a temporarty situation.

And DMP, the same goes for you my friend. I know how awful it was when I was in the hospital feeling miserable, but there is healing. It might not be as fast as you want it to be but it will come, please keep the faith. Log in or register to post comments indydorsey13 Log in or register to post comments indydorsey13 Pneumonectomy ( lung removed ) Yes, DMP, he had his tubes, ventilator, oxygen, eperderal, etc. all removed by day # 2. This is certainly taking ALL his patience....always a VERY active man, and now just to walk to the bathroom makes him VERY short of breath... Only 6 days since his surgery.... I am encouraging him in everyway I can.. I try to not be over protective with him..I am very caring, and it's my personality to be a caregiver...( plus I love him & do NOT like seeing him go through all that he is going through ) Why do you still have your drain tubes ? I know there is a good reason, but I hate to hear that you are still having to go through that to...

( if I understood you correctly ) He does his breathing exercising and coughs up sometimes, but coughing is VERY painful..... I pray for you that you will see a lot of progress soon... Thanks for you mes. Log in or register to post comments PBJ Austin Drain tubes, etc Indy, I had drain tubes, epidural, catheter, etc for 5 days!! I was so glad when they finally took those out. Coughing was the most excrutiating pain I've ever known. It hurt so badly I would ask my family to leave the room because I didn't want them to see me in so much pain as I coughed. My doctor made it clear it's necessary to cough up stuff otherwise I could get pneumonia. But now I can cough normally with no pain. He might find yawning and sneezing to be tough too, as you must draw a deep breath when doing that. It sounds like your husband is doing better than I did. His tubes were removed sooner and he wasn't hospitalized as long as I was. Maybe this means his recovery will be faster than mine? I certainly hope so. It sounds to me like he is making good progress and he's doing very well at this stage.

I know it doesn't seem like it, but I do believe this. If you feel it is appropriate please show him these posts, I pray it will provide him some hope. Log in or register to post comments cabbott It takes time When I was facing lung surgery, some friends of minelet me know that they were sure I'd be fine. They had a friend who was born with only one lung. He was into mountain climbing! My doctors all agreed with them that one lung IS sufficient for us to get enough oxygen to carry on activities. But it takes time to adjust to having less than two lungs. The meds they give us for surgery absolutely exhaust us too. The nurse told me that it takes 3 to 4 weeks for those things they give us for surgery to get out of the body. I had two major surgeries in less than 2 weeks and it was a month and a half before I felt like walking outside safely. She said that was normal and was as much due to the drugs I had during the operation as the changes in my body. The surgeon also repeatedly urged me to do the breathing treatments. They are boring, discouraging, and I don't care for the aparatus.

However, they prevent pneumonia, strengthen what's left, and they are exercise. I set mine near the computer (one thing I could do after my eyes were able to focus) and tried to make myself do it on a regular basis, like before I started in on another game of backgammon(one of my favorite timewasters). Another thing that really helped me was that my mom took me to a nearby business mall where folks walked. It was totally flat, weather protected, and mostly empty. There were chairs around for when I gave out. I more or less shuffled the first few times. When I could walk a mile inside, I knew I was ready for outside. It took time, but my activity level did come back to normal. The nurses had ways of dealing with shortness of breath while in bed (another problem I had at first).

They yelled at me for crying (makes it much worse), told me to keep drinking (keeps mucus thinner and easier to cough up), prop myself to a slant while sleeping or sleep in a lazy-boy (helps with drainage), turn a fan on in my face (the breeze helps a bit so I flipped on my ceiling fan as needed), or open a window (couldn't do that now with the snow!). While I was back to the gym mornings and working full time within a few months, I wasn't terribly happy with coughing. I wasn't involved enough at the time for the pneumonology oncologist, but my doctor mentioned something about going to see a pneumonologist. That doctor specializes in lung diseases, allergies, and such. They also have pneumonology rehab specialists. I went, they prescribed various concoctions to ease my breathing, and I got back to something I was happy with. The doctor reminds me from time to time that I am getting older and we all slow down with age. I'm in my early 50's and totally ignore that!

Accepting slowing down doesn't sit well with me as long as my head is up and my feet are down.The yoga I have Friday's and the morning workouts the rest of the week are my structured rehab exercises. I'm facing the possibility of more surgery in the next few months (we hope that CAT scan was just a fluke, but it'll be what it'll be come April 2nd), and I know I will ask for formal rehab assistance if the above things don't cut it. That way I can get the expert's opinion of what exercises I need to do (no doubt more boring than yoga or Y workouts!). Good luck! Me Too A little excercise and alot of patience. That's what I keep hearing. I don't even describe it as a 'shortness of breath', it is more of a struggle to breath. And it gets tougher when the panic starts to play a part and I know I have to keep that in perspective as well. The med staff and people who have gone through it promise me it gets better. I believe that if it has gotten better for so many others it will for me as well. Thanks for the post. I needed to see it as much as you had to post it.

left lung removed I also had my entire left lung removed on July 31, 2007. Mine had not spread. While in the hospital I had to take walks, with my husbands assistance, 2 times a day. I was extremely short of breath. I would have to stop & rest several times while walking down the hall. I continued to be short of breath for probably about 3 months. When my husband & I would go grocery shopping, once I entered the store I would have to stop & use my albuterol & wait until I could catch my breath & go on. My right lung has expanded, which is normal, so I do very well now. I can't do much housework without taking a break, but I can deal with that. I go to a exercise class 3 times a week for an hour each time. That has helped me tremendously. Just be patient & you should find that in time you will do a lot better.

Left Lung removed Oct 1984 Its great to read post about a personal subject that I have lived with for almost 28 years, at the age of 26 I was Diagnosed with Non-Hodgkins lyphoma in My left Lung, The lung was getting close to collasping, so it had to be removed very quicky, fear that the cancer would spread to My vital organs. Prior to My illness, I was very active in running and long distance bike riding, after the surgery and rehabilitaion, it was pretty devestating to know that I would never be able to perform athleticly like I once could, for many years I shut down and went into along period of depression, however after time taking long walks with My dogs in the park raised My spirits alot. From time to time I would test the limits of My breathing by doing treadmills or just simply jogging for short distance, this was pretty discouraging due to the pain and recovery stressed upon My right lung.

Many of My friends are bike riding now, so last week I bought a road bike and giving it a go, its alot easier then running however there still is that long recovering time catching My breath, after 10 days I am not discouraged and have found that it is fun to be out on the road again riding. Will keep ya updated on how this is going. Mesothelioma Surgery - Pleurectomy, Decortication, Extrapleural Pneumonectomy, Biopsy, Pleurodesis - Mesothelioma Treatment Options Surgery Mesothelioma Surgery Several surgical procedures are used to treat mesothelioma. Some mesothelioma surgeries aim to provide a curative effect, while others are performed for palliative purposes (to reduce pain and other symptoms affecting a patient). While treating mesothelioma surgically, a surgeon may remove part of the lining of the chest or abdomen and some of the tissue around it. In treating pleural mesothelioma, sometimes part of the diaphragm, the muscle below the lungs that helps with breathing, is also removed during surgery because the diaphragm is so connected to the pleura (mesothelial lining of the lungs).

Depending on how far the cancer has spread, a lung also may be removed (pneumonectomy). The following are some of the most commonly used surgerical treatments of mesothelioma: Pleurodesis Used to treat pleural mesothelioma , pleurodesis is a surgical procedure that introduces an irritant into the pleural space that creates inflammation. This inflammation effectively eliminates the pleural space, thus preventing fluid build up, or a pleural effusion. Generally used when the pleural effusion is symptomatic, pleurodesis is a treatment administered through a thoracoscopy or existing chest tube. Talc is used most commonly and effectively for this procedure, thus it is often referred to as "talcing" or as a patient having been "talced." This procedure is a common reaction to a pleural effusion, but can limit other treatment options. Pleurodesis is best utilized among mesothelioma patients decline other, more aggressive treatment options or who are not candidates for them. Pleurectomy or Peritonectomy Surgery to remove part of the chest (pleura) or abdomen lining (peritoneum) and some of the tissue surrounding it.

This procedure is performed for a variety of disorders including pleural effusion, malignant mesothelioma , and trauma. Peritonectomy Malignant peritoneal mesothelioma (abdominal mesothelioma) is sometimes treated surgically with the removal of the peritoneum. In addition to a peritonectomy, tumor debulking or cytoreduction surgery may also be performed to remove cancerous tumor masses. Pleurectomy Used in cases of malignant pleural mesothelioma , a pleurectomy involves the removal of part of the pleura . Medical literature at times refers to the removal of all or part of the the parietal pleura as a pleurectomy (the parietal pleura is the outer layer of the pleura). Other references to a pleurectomy indicate the removal of both the parietal and visceral pleura. The recent trend seems to be to call removal of both parietal and visceral pleura as a pleurectomy/decortication (see below). The parietal pleura is tightly fused to the diaphram, so some of this muscle may also be removed during surgery.

Pleurectomy/Decortication Decortication is the surgical removal of all or part of the membrane and/or outer layer of an organ. In the case of a lung, this would indicate the removal of the visceral pleura. The visceral pleura is the part of the pleura that touches the lung. The outer part of the pleura, or parietal pleura, is generally removed at the same time, thus a Pleurectomy/Decortication is often Pneumonectomy Surgery to remove a lung is known as a pneumonectomy (new-moe-NEK-toe-me). A simple pneumonectomy is the removal of just the affected lung. Extrapleural Pneumonectomy (or EPP) In addition to the pneumonectomy (the surgical removal of the lung), an extra pleural pneumonectomy also includes the removal of the pleura , diaphragm, and pericardium (mesothelial lining of the heart). You can view a web cast from Brigham and Women's Hospital in Boston of this procedure being done by Dr. David Sugarbaker: see the extrapleural pneumonectomy (EPP) web cast here .

Last update: December 03, 2015. 02:56:34 pm. Contact Us Today A quick guide to what's on this page Types of surgery for lung cancer Surgery is mostly used to treat non small cell lung cancers. It is not normally used to treat small cell lung cancer. If your cancer is very near your heart, windpipe, food pipe (oesophagus) or a major blood vessel, it may be better for you to have other treatments. Your doctor may suggest chemotherapy or radiotherapy instead. If you have other health problems such as a severe heart condition or other lung disease, you may not be fit enough to have major lung surgery. There are three main types of surgery used to treat lung cancer. These are Removing a section of lung Removing a lobe of the lung (lobectomy) Removing the whole lung (pneumonectomy) During your operation your surgeon will remove some of the lymph nodes from around the lung. The surgeon sends the lymph nodes to the laboratory where they are examined under a microscope. If the nodes contain cancer cells this may affect the treatment that you need after the surgery. Keyhole surgery is sometimes used to remove early, small non small cell lung cancers.

In this type of surgery the surgeon removes the cancer through several small cuts rather than 1 larger wound. If your cancer has spread A major operation to remove your cancer will not be the right treatment for you if your cancer has spread to anywhere else in your body . Your doctor will probably suggest another type of treatment such as chemotherapy and radiotherapy instead. View a summary of treating lung cancer . Surgery for lung cancer Surgery is mostly used to treat non small cell lung cancer . But it may be better for you to have other cancer treatment such as radiotherapy , chemotherapy or possibly both if your cancer is very near any of the following structures Heart Food pipe (oesophagus) Major blood vessels Surgery is not normally used to treat small cell lung cancer , except if it is at a very early stage. This is because small cell lung cancer has usually spread beyond the lung when it is diagnosed and so it is not then possible to remove it all with surgery. Chemotherapy and radiotherapy are more often used than surgery for small cell lung cancer. The type of surgery you have will depend on the size of the cancer and its position within the lung. Removing lobes of the lung Lobectomy is the removal of one lobe of the lung.

Your surgeon will recommend this type of operation if they think the cancer is just in one part of one lung. It is the most common type of operation for lung cancer. Bilobectomy is the removal of two lobes of the lung. A small number of people with lung cancer have an operation called a sleeve resection. Your surgeon may do this to avoid removing your whole lung if the cancer is in the central area of the lung and is growing into one of your main airways (bronchi). In this situation a simple lobectomy can't be done. Sleeve resection involves removing the affected section of the bronchus, and any surrounding cancer in the lobe. Removing the whole lung Doctors call the operation to remove the whole lung a pneumonectomy (new-mon-ek-tom-ee). Your specialist will recommend this operation if the tumour is in the central area of the lung and involves either the 2 lobes on the left or the 3 lobes on the right. Many people worry that they won't be able to breathe properly with only one lung but you can breathe normally with only one lung. If you had breathing problems before the operation, you will probably still be breathless afterwards.

Your doctor will arrange for you to have breathing tests before the surgery to help decide if this operation is right for you. Removing a section of lung Some operations remove particular areas of the lung. A wedge resection removes an area of the lung that includes part of one or more lobes. A segmentectomy removes areas of the lung along with their veins, arteries and airways. These types of operation are used when the specialist thinks the cancer has been diagnosed early and is only in one very small area. If the specialist thinks the cancer cells could be anywhere else in the lung they will not recommend this type of operation. Keyhole surgery for lung cancer Surgeons can sometimes use keyhole surgery to remove very small, early, non small cell lung cancers. This type of surgery is called video assisted thoracoscopic surgery (VATS). The surgeon passes a flexible tube with a telescopic camera through a small cut in the chest. This allows them to examine the lungs under video guidance. They then make 1, 2 or 3 small cuts (incisions) on the side of the chest. They insert the surgical tools through the cuts to carry out the surgery. Removing lymph nodes During your operation your surgeon will remove some of the lymph nodes from around the lung.

This is because the lymph nodes may contain cancer cells that have broken away from the main cancer. The surgeon sends the lymph nodes to the laboratory where they are examined under a microscope. If the nodes contain cancer cells this may affect the treatment that you need after the surgery. If your cancer has spread A major operation is unlikely to be the right treatment for you if your cancer has spread to anywhere else in your body. If there are cancer cells anywhere else, the operation will not remove them and your doctor will probably suggest another type of cancer treatment such as chemotherapy and radiotherapy instead. Your general health If you have other health problems such as a severe heart condition or other lung disease, you may not be fit enough to have major lung surgery. Your surgeon will examine you thoroughly and do quite a few tests before you decide together whether an operation is right for you and which type of operation. Your doctor may recommend radiotherapy instead of surgery and you can find information about this in our section about radiotherapy for non small cell lung cancer .

Lung surgery: MedlinePlus Medical Encyclopedia Remove tumors, such as solitary pulmonary nodule Inflate lung tissue that has collapsed (This may be due to disease such as chronic obstructive pulmonary disease, or an injury.) Remove infection in the chest cavity (empyema) Stop fluid buildup in the chest cavity (pleurodesis) Remove a blood clot from the pulmonary artery ( pulmonary embolism ) Treat complications of tuberculosis Video-assisted thoracoscopic surgery can be used to treat many of these conditions. In some cases, video surgery may not be possible, and the surgeon may have to switch to an open surgery. Risks Risks of this surgery include: Failure of the lung to expand Injury to the lungs or blood vessels Need for a chest tube after surgery Pain Damage to the diaphragm, esophagus, or trachea Death Before the Procedure You will have several visits with your health care provider and undergo medical tests before your surgery.

Your provider will: Do a complete physical exam Make sure other medical conditions you may have, such as diabetes , high blood pressure , or heart or lung problems are under control Perform tests to make sure that you will be able to tolerate the removal of your lung tissue, if necessary If you are a smoker, you should stop smoking several weeks before your surgery. Ask your provider for help. Always tell your provider: Which drugs, vitamins, herbs, and other supplements you are taking, even ones you bought without a prescription If you have been drinking a lot of alcohol, more than 1 or 2 drinks a day During the week before your surgery: You may be asked to stop taking drugs that make it hard for your blood to clot. Some of these are aspirin, ibuprofen (Advil, Motrin), vitamin E, warfarin (Coumadin), clopidogrel (Plavix), or ticlopidine (Ticlid). Ask your provider which drugs you should still take on the day of your surgery. Prepare your home for your return from the hospital. On the day of your surgery: Do not eat or drink anything after midnight the night before your surgery. Take the medicines your doctor prescribed with small sips of water.

Your provider will tell you when to arrive at the hospital. After the Procedure Most people stay in the hospital for 5 to 7 days after open thoracotomy. Hospital stay for a video-assisted thoracoscopic surgery is most often shorter. You may spend time in the intensive care unit (ICU) after either surgery. During your hospital stay, you will: Be asked to sit on the side of the bed and walk as soon as possible after surgery. Have tube(s) coming out of the side of your chest to drain fluids and air. Wear special stockings on your feet and legs to prevent blood clots. Receive shots to prevent blood clots. Receive pain medicine through an IV (a tube that goes into your veins) or by mouth with pills. You may receive your pain medicine through a special machine that gives you a dose of pain medicine when you push a button. This allows you to control how much pain medicine you get. You may also have an epidural placed. This is a catheter in the back that delivers pain medicine to numb the nerves to the surgical area. Be asked to do a lot of deep breathing to help prevent pneumonia and infection. Deep breathing exercises also help inflate the lung that was operated on.

Your chest tube(s) will remain in place until your lung has fully inflated. Outlook (Prognosis) The type of problem being treated How much lung tissue (if any) is removed Your overall health before surgery Alternative Names Thoracotomy; Lung tissue removal; Pneumonectomy; Lobectomy; Lung biopsy; Thoracoscopy; Video-assisted thoracoscopic surgery; VATS Images Pulmonary lobectomy - series References Alfille PH, Wiener-Kronish JP, Bagchi A. Preoperative evaluation. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray & Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 27. Feller-Kopman DJ, Decamp MM. Interventional and surgical approaches to lung disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 101. Putnam JB. Lung, chest wall, pleura, and mediastinum.

In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier Saunders; 2017:chap 57. Read More Lobectomy | Johns Hopkins Medicine Health Library << Back to Pulmonary Tests and Procedures What is a lobectomy? A lobectomy is a surgery to remove one of the lobes of the lungs. The lungs have sections called lobes. The right lung has 3 lobes. The left lung has 2 lobes. A lobectomy may be done when a problem is found in just part of a lung. The affected lobe is removed, and the remaining healthy lung tissue can work as normal. A lobectomy is most often done during a surgery called a thoracotomy. During this type of surgery, the chest is opened. In most cases, during a lobectomy the cut (incision) is made at the level of the affected lobe. The incision is most often made on the front of the chest under the nipple and wraps around the back under the shoulder blade. The surgeon gets access to the chest cavity through the exposed ribs to remove the lobe.

In some cases, a video-assisted thoracoscopic surgery (VATS) is used to do a lobectomy. This is a less-invasive procedure. With this type of surgery, 3 or 4 small incisions are used instead of 1 large incision. Small tools are put into the chest cavity. One of the tools is called a thoracoscope. It’s a tube with a light and a tiny camera that sends images to a computer screen. This shows the internal organs on the screen. The small tools are used through the other incisions to do the surgery. Why might I need a lobectomy? A lobectomy may be done when a problem has been found in one lobe. A lobe may be removed to avoid spread of disease to the other lobes. This may be the case with tuberculosis or certain types of lung cancer. Health conditions of the chest and lungs that may be treated with lobectomy include: Tuberculosis (TB). This is an ongoing (chronic) bacterial infection that usually infects the lungs. Lung abscess. This is an area of pus that may form in the lung. If the abscess does not go away with antibiotic medicine, it may need to be removed. Emphysema.

This is a chronic illness caused by the breakdown of the elastic fibers in the lungs. This makes it harder for the lungs to move when you breathe. Benign tumor. This is a growth that is not cancer. It that can press on large blood vessels and affect the function of other organs. Lung cancer. This is a type of cancer that may affect the bronchi, one or more lobes of the lungs, the pleural lining, or other lung tissue. If not treated, it can spread to other parts of the body. Fungal infection. Fungi can grow in the body and cause infections. Your healthcare provider may have other reasons to advise a lobectomy. What are the risks of a lobectomy? All procedures have some risks.

The risks of this procedure may include: Infection Air in the space between the lung covering (pleural space) that causes the lung to collapse (pneumothorax) Bleeding A tube-like opening between the airway (bronchus) and pleural space that causes air or fluid to leak into the chest (bronchopleural fistula) An area of pus in the chest cavity (empyema) Fluid in the space between the lung and inner chest wall (pleural effusion) Your risks may vary depending on your general health and other factors. Ask your healthcare provider which risks apply most to you. Talk with him or her about any concerns you have. How do I get ready for a lobectomy? Your healthcare provider will explain the procedure to you. Ask him or her any questions you have. You may be asked to sign a consent form that gives permission to do the procedure. Read the form carefully. Ask questions if anything is not clear.

Tell your healthcare provider if you: Are pregnant or think you may be pregnant Are allergic to contrast dye or iodine Are sensitive to or allergic to any medicines, latex, tape, or anesthetic medicines (local and general) Take any medicines, including prescriptions, over-the-counter medicines, vitamins, and herbal supplements Have had a bleeding disorder Take blood-thinning medicine (anticoagulant), aspirin, or other medicines that affect blood clotting Make sure to: Stop taking certain medicines before the procedure, if instructed by your healthcare provider Not eat or drink for 8 hours before the procedure, or as instructed by your healthcare provider Stop smoking Plan to have someone drive you home from the hospital Follow any other instructions your healthcare provider gives you You may have blood tests or other tests or exams before the procedure. Your healthcare provider will tell you more. What happens during a lobectomy? The procedure almost always needs an inpatient stay, meaning that it may be done as part of a longer stay in the hospital. The way the procedure is done may vary. It depends on your condition and your healthcare provider's methods. In most cases, the procedure will follow this process: You will be asked to remove your clothes. You will be given a hospital gown to wear.

You may be asked to remove jewelry or other objects. You will lie down on an operating table. An intravenous (IV) line will be put into your arm or hand. You may be given antibiotics before and after the procedure. You will be given general anesthesia. This is medicine that prevents pain and lets you sleep through the procedure. A breathing tube will be put into your throat and hooked up to a breathing machine (ventilator). Your heart rate, blood pressure, and breathing will be watched during the procedure. A soft, flexible tube (catheter) may be put into your bladder. This is to drain urine during the procedure. Hair in the area of surgery may be trimmed. The skin in the area will be cleaned with an antiseptic solution. A cut (incision) will be made on the front of your chest at the level of the lobe to be removed. The incision will go under your arm around to your back. When the ribs can be seen, a special tool will be used to spread them apart. The lung lobe will be removed. One or more tubes may be put into your chest. These are to help remove air and fluid after surgery.

The skin incision will be closed with stitches (sutures) or staples. A bandage or dressing will be put on the area. A thin tube (epidural catheter) may be put in the area of the lower spine. This is done to send pain medicine into your back. It may be done in the operating room or in the recovery room. What happens after a lobectomy? After the procedure, you will spend some time in a recovery room. You may be sleepy and confused when you wake up from general anesthesia or sedation. Your healthcare team will watch your vital signs, such as your heart rate and breathing. You’ll be given pain medicine if you need it. A chest X-ray may be done right after the surgery. This is to make sure your lungs are OK. You will stay in the hospital for several days. You may have one or more chest tubes near the incision to drain air or fluid from the chest. The chest tubes may cause pain when you move, cough, or breathe deeply. They will be taken out before you leave the hospital. You will be taught deep-breathing exercises and coughing methods to help your lungs re-expand after surgery. This is to help breathing and prevent pneumonia.

You may need oxygen for a period of time after surgery. In most cases, the oxygen will be stopped before you go home. Or, you may need to go home with oxygen. You will be told to move around as much as you can while in bed, and get out of bed and walk as soon as you can. This will help your lungs heal faster. You may be given fluids to drink a few hours after surgery. You will be given food to eat as you are able. Before you leave the hospital, you’ll make an appointment for a follow-up visit with your healthcare provider. You will go home when your healthcare provider says it’s OK. Someone will need to drive you home. At home, keep the incision clean and dry. Your healthcare provider will give you bathing instructions. The stitches or staples will be removed during a follow-up appointment. The incision may be sore for several days. Your chest and shoulder muscles may ache, especially with deep breathing, coughing, and activity. You can take pain medicine as advised by your healthcare provider. Aspirin and certain other pain medicines may increase bleeding. Make sure to take only the medicines your healthcare provider advises. Keep doing the breathing exercises you learned in the hospital.

Slowly increase your physical activity as tolerated. It may take several weeks to return to normal. You may need to avoid lifting heavy items for several months. This is to prevent strain on your chest muscles and the incision. While you’re healing, take steps to prevent exposure to: Upper respiratory infections, such as colds and flu Tobacco smoke

Question: A pneumonectomy is the removal or part-removal of which part of the human body?
Answer: Lung